Clinical metric of tumor mutational burden depicts colorectal cancer patients at the extremes.

IF 2.8 3区医学 Q2 ONCOLOGY

Clinical & Translational Oncology Pub Date : 2025-02-21 DOI:10.1007/s12094-025-03873-6

Ming Zheng

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引用次数: 0

Abstract

Purpose: Rare cases of colorectal cancer patients with exceptionally good or poor prognosis often remain overlooked, limiting insights into prognostic factors and underlying mechanisms.

Methods: This study developed an analytical framework to investigate cancer patients at the extremes using tumor mutational burden (TMB). By analyzing data from 1277 colorectal cancer patients who did not receive immunotherapy, this analysis assessed how patient survival varies with a broad range of TMB levels.

Results: Among patients with TMB ≤ 10 mutations per megabase (mut/Mb), increasing TMB was associated with worse survival outcomes. In contrast, patients with TMB > 10 mut/Mb showed increasingly improved survival. Notably, a small subgroup (3.83%) with TMB > 60 mut/Mb had significantly better survival outcomes.

Conclusions: These findings highlight TMB's dual role in colorectal cancer progression. This study suggests that atypical patients can coexist within the same "disease continuum" with typical patients, under the universal context unified by a shared cancer hallmark. TMB provides a useful biomarker for identifying these extremes, offering a clinical metric to better predict patient outcomes and personalize treatment strategies.

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肿瘤突变负荷的临床指标描述了极端的结直肠癌患者。

目的：罕见的结直肠癌患者预后异常好或异常差的情况往往被忽视，限制了对预后因素和潜在机制的认识。方法：本研究利用肿瘤突变负荷（tumor mutational burden， TMB）建立了一个分析框架来研究极端情况下的癌症患者。通过分析1277名未接受免疫治疗的结直肠癌患者的数据，该分析评估了患者的生存如何随着TMB水平的广泛变化而变化。结果：在TMB≤10个突变/兆基（mut/Mb）的患者中，TMB增加与更差的生存结果相关。相比之下，TMB患者bbb10 mut/Mb的生存率越来越高。值得注意的是，TMB为60 mut/Mb的一小部分亚组（3.83%）的生存结果明显更好。结论：这些发现突出了TMB在结直肠癌进展中的双重作用。这项研究表明，非典型患者可以与典型患者共存于同一个“疾病连续体”中，在由共同的癌症标志统一的普遍背景下。TMB为识别这些极端情况提供了有用的生物标志物，为更好地预测患者预后和个性化治疗策略提供了临床指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical & Translational Oncology 医学-肿瘤学

CiteScore

6.20

自引率

2.90%

发文量

240

审稿时长

1 months

期刊介绍： Clinical and Translational Oncology is an international journal devoted to fostering interaction between experimental and clinical oncology. It covers all aspects of research on cancer, from the more basic discoveries dealing with both cell and molecular biology of tumour cells, to the most advanced clinical assays of conventional and new drugs. In addition, the journal has a strong commitment to facilitating the transfer of knowledge from the basic laboratory to the clinical practice, with the publication of educational series devoted to closing the gap between molecular and clinical oncologists. Molecular biology of tumours, identification of new targets for cancer therapy, and new technologies for research and treatment of cancer are the major themes covered by the educational series. Full research articles on a broad spectrum of subjects, including the molecular and cellular bases of disease, aetiology, pathophysiology, pathology, epidemiology, clinical features, and the diagnosis, prognosis and treatment of cancer, will be considered for publication.